1619952728 NPI number — DR. MAISLYN ANNMARIE CHRISTIE M.D.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1619952728 NPI number — DR. MAISLYN ANNMARIE CHRISTIE M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CHRISTIE
Provider First Name:
MAISLYN
Provider Middle Name:
ANNMARIE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1619952728
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2309 GOLD MINE RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BROOKEVILLE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20833-2233
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-570-3459
Provider Business Mailing Address Fax Number:
301-774-5823

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3300 OLNEY SANDY SPRING RD
Provider Second Line Business Practice Location Address:
SUITE 330
Provider Business Practice Location Address City Name:
OLNEY
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20832-1494
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-570-2003
Provider Business Practice Location Address Fax Number:
301-774-5823
Provider Enumeration Date:
12/12/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208000000X , with the licence number:  D38739 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: KW0CH5 . This is a "BCBS MD" identifier . This identifiers is of the category "OTHER".
  • Identifier: B846 . This is a "BCBS OF NCA" identifier . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com